This toolkit is meant for educational purposes only. The information within it should not be used to diagnose or treat brain injury in your clients.

Photo: Communication after Brain Injury

Communication after Brain Injury

Communication is defined as a process by which individuals share and exchange information using mutually understood symbols, signs, and behaviours.1 Communication takes place when we are sharing ideas and expressing our thoughts and feelings using speech, body language, and writing. It is essential to successful relationships, work, leisure, and education, and is therefore fundamental to quality of life.2

Problems with communication are a potential consequence of brain injury. The types of communication problems that can affect a survivor vary, and depend on how the person functioned before the injury, and the specifics of their brain injury (e.g., how the brain was injured, how severe the injury was, and what part of the brain or body was injured), among other possible factors that can affect communication.3

Communication is a complex process, involving not only the ability to produce and understand speech, but also the use and interpretation of signs, symbols, gestures, body language, and written language to convey a message, and understand an incoming message. Normally, the brain carries out all these steps quickly and without intense effort. But for a person with a brain injury, one or more of the brain functions needed to carry out these steps can be impaired, making speech and/or language for a survivor challenging and frustrating.4

While traumatic brain injury is complex and varies from person to person, a common pattern of injury involving the frontal and temporal lobes, which are responsible for cognitive and sound processing, respectively, tends to produce communication difficulties.5 It is reported that over 75% of brain injury survivors will experience some form of communication impairment.6 The most common communication disorders affecting traumatic brain injury survivors are known as cognitive communication disorders.7 They encompass difficulties with listening, speaking, conversation, reading, and writing, and are the result of problems with cognitive functions such as attention, thinking, concentration, memory, information processing, reasoning, and problem-solving.7

Someone with a cognitive communication disorder can (some examples)5:

  • Be overly talkative or speak very little
  • Be inefficient and tangential when communicating
  • Jump suddenly from one topic to the next
  • Provide confused or inaccurate accounts


1Merriam-Webster, “Definition of Communication.” [Online]. Available:

2E. C. Hora, L. V. Santana, L. de Jesus Satos, G. de Oliveira Souza, A. V. Pimentel, N. T. C. Bezerra, S. R. de Freitas Doria, T. P. V. de Carvalho, A. A. Mendes Junior, J. A. Rodrigues, R. J. P. L. Lopes, and R. Fakhouri, “Chapter 20: Communication Disorders Following Traumatic Brain Injury,” pp. 467–490.

3National Institute on Deafness and Other Communication Disorders, “Traumatic Brain Injury: Cognitive and Communication Disorders,” Brainline, 2008. [Online]. Available:

4Calgary Brain Injury Program, Alberta Health Services, “Communication and Language Changes after a Brain Injury,” After Brain Injury: A Guide for Patients and their Families, 2018. [Online]. Available:

5L. Togher, C. Wiseman-Hakes, J. Douglas, M. Stergiou-Kita, J. Ponsford, R. Teasell, M. Bayley, and L. S. Turkstra, “INCOG recommendations for management of cognition following traumatic brain injury, Part IV: Cognitive communication,”J. Head Trauma Rehabil., vol. 29, no. 4, pp. 353–368, 2014.

6S. MacDonald, “Introducing the model of cognitive-communication competence: A model to guide evidence-based communication interventions after brain injury,” Brain Inj., vol. 31, no. 13–14, pp. 1760–1780, 2017.

7S. MacDonald and C. Wiseman-Hakes, “Knowledge translation in ABI rehabilitation: A model for consolidating and applying the evidence for cognitive-communication interventions,” Brain Inj., vol. 24, no. 3. pp. 486–508, 2010.